Payer

 The Cigna Group saw a 34% decline in profits year over year as the company faces rising costs within its insurance business, according to its fourth quarter earnings report published Jan. 30.

Three TeamHealth-affiliated physician groups have filed a lawsuit against Blue Cross and Blue Shield of Texas, alleging that the insurer breached its contract by improperly reducing reimbursements for emergency services. 

The Cigna Group will invest in making prior authorization faster and simpler in 2025, CEO David Cordani said. 

Rhode Island lawmakers have introduced legislation that would prohibit payers from requiring prior authorization for treatment or services ordered by a patient's primary care provider. 

From preliminary approvals to agreements with the federal government, these are five recent legal settlements involving UnitedHealth Group and its subsidiaries.

UnitedHealthcare has reached a settlement to resolve three proposed class action lawsuits alleging that the insurer wrongfully denied coverage for a specialized cancer treatment that plaintiffs claim is more effective but significantly more expensive than traditional radiation therapy. 

The number of prior authorization determinations issued by Medicare Advantage insurers continued to grow in 2023, according to a new report from KFF. 

Here are 10 updates on UnitedHealth Group and its subsidiaries that Becker's has reported since Jan. 9: 

Alabama has the highest average in-network denial rate for ACA insurers, while South Dakota has the lowest, according to KFF. 

Insurers on the ACA marketplace denied around one in five in-network claims in 2023, according to a report from KFF published Jan. 27.